Kotov Syndrome
by monicawoe
Summary: Written for the prompt: Lucifer and Sam are both psychiatric patients in a ward, forming some sort of dependent bond with one another. AU set after 4x22 - Sam and Dean are both whisked away from the chapel, but not together. Sam has set the Devil free, and believes Dean is dead. He breaks. This what happens afterwards.


It's cold, Jeremy thought as he turned the corner with his food cart. The temperature at St. Michael's Psychiatric Institute was normally kept at a steady 72 degrees, but today it felt colder.

He took the elevator up one level, pushed his cart out into in Hall C and stopped to check his chart. Only about half the rooms were occupied. This whole wing was a recent addition, and the rooms still smelled like fresh paint, even two months later. His first stop was room 58 — Winchester, S.

Picking up the breakfast tray, Jeremy knocked on the door to Mr. Winchester's room before opening it. Sam Winchester was still asleep, or he appeared to be anyway. He was lying on his side, facing the barred window across from his bed. He'd pushed his blanket down to the foot of his bed, and his broad back expanded slowly with every breath.

At least he was sleeping for longer stretches now. The night shift had said he'd been totally quiet during the night. Sam's first few weeks had been interesting, to say the least.

Rumor had it they'd found him wandering through the state park just off Route 70. From what he'd overheard in the break room, Sam had gone through some heavy-duty withdrawal during his first week as a patient. They'd suspected narcotics at first, but none of the other CNAs or nurses had ever seen anybody with symptoms like Sam's. He spent the first few days at the Institute alternating between violent seizures, and fevered hallucinatory episodes that usually ended up with him crying — his broken, raspy voice repeating an endless litany of one phrase over and over: "I'm sorry."

Sam spent his lucid periods hunched in on himself, trying to hide his large frame. His eyes looked burdened, wracked with guilt. Jeremy had seen it before — especially with addicts. They had to fight their bodies tearing themselves apart while their minds came back into focus, usually bringing back memories of all the awful things they'd done while under the influence. He'd seen it before, and that's what he was seeing in Sam, he was sure of it. But Sam's tox screen had turned up nothing except unusually high sulfur levels, which though unusual, wasn't addictive last time he checked.

One of the reasons Jeremy had become a CNA was because he genuinely wanted a chance to help people. He'd come from a small family, and had lost everybody but his Dad, who'd relocated to Florida with his third wife a little over a year ago. That was the shitty thing about life — people got sick for one reason or another, and more often than not, they didn't get better.

Jeremy had applied at St. Michael's because he felt like the patients there needed his help the most. There was something even more depressing about being physically sound but unable to enjoy any of it. Sometimes he wondered about what the lives of the patients here had been like before they'd gotten sick. What had Sam's life been like? It couldn't have been half as crazy as they said. It couldn't have been.

On more than one occasion, Jeremy had to help restrain Sam. Usually, he was more than capable of handling the patients by himself, but Sam was a big guy — six and a half feet of solid muscle. Jeremy had been at the top of his wrestling team back in his college days and could usually handle guys larger than him, but Sam knew how to fight. He'd been through a lot; that much was obvious — and if even half of what they said about him was true, then he was extremely dangerous. From what Matt in maintenance had told him, Sam Winchester was presumed dead along with his brother Dean. They'd been suspected of all kinds of crimes a few years back, but nothing had ever been proven.

The rooms in Hall C were all set up the same — plain wooden table with a matching wooden chair to the left of the door, one large medical bed in the center of the room, and two barred windows on the far wall.

Jeremy put the tray down on Sam's table quietly and flipped on one of the two overhead lights. They'd installed the newer model halogen bulbs in this wing, and even though they were supposed to be more "natural," they were so damn bright that most of the patients wanted them off whenever possible.

There was a slight shift in Sam's breathing, and then he sat up, still facing the window.

"Sleep okay?"

Sam didn't answer. He barely ever answered. He'd been quiet since he'd gotten through the withdrawal.

"Pancakes today. They look kind of gray, but that's because they've got barley in them. They're actually pretty good." Jeremy pulled the cover off the tray, arranged the little plastic fork and knife to the right and left of the plate, and turned towards the door to leave.

"He says he's coming to see me." Sam was still facing the window.

"Who is?" Jeremy didn't really need to ask. There was only one _he_Sam ever complained about: the voice in his head. The voice he was convinced was the Devil.

Sam didn't answer. He turned away from the window, and looked over his shoulder at Jeremy, then at the breakfast tray. There were heavy bags under his eyes, and the stubble on his face was a stark contrast to his pale skin.

"I'll let Doc Martin know. He'll be in to see you later," Jeremy grabbed for the door handle.

"He's here already, isn't he?" Sam asked, pushing himself off the bed. He stepped into his size thirteen slippers and padded over to the table, picking up one of the small pancakes and sniffing at it suspiciously.

"The doc? No, he gets in at—"

"Lucifer. He checked in here last night." Sam took a bite out of the pancake and walked back towards the window.

"Uh. I'll ask Doc Martin, okay?" Jeremy stepped out, eager to avoid any more weird questions.

From what he'd been told, Sam's delusions about the Devil were rather common, psychologically speaking. That didn't make them any less unnerving.

* * *

The eerieness of Sam's statement didn't sink in until much later that day. Frank, who'd been at St. Michael's for years and who'd shown Jeremy the ropes back when he'd first started, was on shift in the day room that afternoon when Jeremy brought Sam over.

Most of the patients loved going to the day room, at least they did after their first few weeks. Sam had always gone without argument — bordering on apathetic. But not today. Today he'd been on edge the whole way there — he even tried to head back to his room a few times, but Jeremy convinced him to keep going. When they got to the day room, Sam immediately focused on a new patient leaning against the wall near the rack of books. He was holding a worn Bible, paging through it casually, an amused expression on his face.

Sam walked around him in a wide arc, heading for his table in the far corner. He sat down, back to the wall, staring at the man. Jeremy would have been lying if he'd said he couldn't see how scared Sam was — arms folded across his chest, head down, eyes looking up and to the right — towards the new patient.

At first glance, Jeremy really had no idea why. The man looked harmless enough. Cropped hair, average build. He was a good four inches shorter than Sam.

"Checked this one in last night. Thinks he's the Devil." Frank nudged Jeremy in the ribs. "We should get this one together with Winchester, huh?"

"I think that'd be a bad plan," Jeremy said, watching Sam's hands shake as he folded them together on the table and tried to focus on the chess set in front of him.

"Joking," Frank said, rolling his eyes.

Frank droned on about his weekend conquests, which Jeremy had to assume were mostly fictional, for the sake of his own sanity. He watched as Sam lined up the pieces of the chessboard just the way he liked them. He was the only patient Jeremy had ever seen that had a specific order for the pawns. How Sam could tell them apart, he had no idea. But he could.

The new patient — "Nick," according to Frank — put his book back down and walked over to Sam's table.

Jeremy tensed, waiting for Sam's reaction, but stayed where he was. Often, trying to intervene early made things much worse. He watched closely as Nick stood by the empty chair across from Sam for nearly a full minute before Sam nodded at the chessboard.

They ended up playing for nearly an hour, never saying a word.

* * *

"So you and Nick got along pretty well, huh?" Jeremy asked when he came into Sam's room that night to pick up his dinner tray.

Sam was standing by the window, watching the sun set. He either didn't hear the question, or didn't care to answer.

"It's good you found a friend who can play chess as well as you."

"He's not a friend," Sam said, like it was a fact. "And he's not Nick, he's Lucifer. He just looks like Nick because he's wearing him."

"Okay. See you tomorrow, Sam."

"He's here for me."

"He's here because he's sick and he needs help."

"Ask him a question he shouldn't know the answer to."

"Goodnight, Sam." Jeremy knew better than to get too involved in conversations with the patients. He pulled the door shut behind him and pushed Sam's last bizarre request out of his mind.

* * *

The next morning, Jeremy had forgotten Sam's strange advice entirely, until he brought Nick his breakfast. Nick was standing by the window, much like Sam had been the night before.

"Good morning, Nick. My name is Jeremy."

"Jeremy. _God will set free_." He turned away from the window, arms folded across his chest and smirked. "You hated the name growing up. But it's not like Bartholomew was an option either."

Jeremy's breath got stuck in his throat as the man spoke his middle name. He hadn't used it in years — hadn't even put it on his job application. Still, he had to keep his calm. Wouldn't do any good to let his nerves get the better of him.

"What did you bring me?"

"Waffles and fresh fruit. Well they say it's fresh but it's really just from canned fruit cocktail mixes," he said, pulling the cover off the food tray. The back of his head tickled, and he felt a weird sense of vertigo. He hadn't meant to say the last part about the fruit out loud.

"Thank you." Nick walked closer, and Jeremy fought the urge to shrink back. "Have you met the new nurse?"

Jeremy shook his head. "Aren't they all new to you?"

Nick laughed. "Good point." He tilted his head to the side. "This one is special."

There was a clattering sound in the hallway and the unmistakable sound of Sam yelling at the top of his lungs.

Jeremy ran out of Nick's room just in time to see a tray bounce off the hallway wall and fall noisily to the floor.

"Get out!" Sam yelled.

"Fine," said a woman's voice Jeremy didn't recognize. She stepped into the hall a minute later and turned to Jeremy. She had dark hair, darker eyes and an amused expression. "He's kinda grumpy in the mornings, huh?" she whispered, walking up to Jeremy. She held out her hand. "Hi, I'm Meg."

"Jeremy." He took a few steps closer to Sam's room, and shook her hand. "Did you just start?"

"Transferred from Baltimore. I had to get away from the city."

Jeremy nodded and glanced over at Sam's door. "What's he so upset about?"

"Me, I think. Said I was a demon." She shrugged. "I mean I know I have bad hair days sometimes, but I thought today I was doing okay, you know?" She sighed and smiled. "It's fine. I won't take it personally."

"Yeah, that's all you can do really." Jeremy looked from her to Sam's door. "Still, I'd better check on him."

She patted him on the arm. "You're a good man, Jeremy." She walked past him, into Nick's room.

Sam was crouched on the floor with his head down. It took Jeremy a minute to see what he was doing. The floor near Sam's feet was covered in black marks. As Jeremy got closer, he saw that they were symbols of some sort — almost like letters, but not any language he recognized. Sam had drawn a large circle all the way around his bed with something running through the middle — a star. He'd drawn a giant pentacle.

"Everything okay, Sam?" he asked, as he took a few steps closer, careful to not step on the marks. "What are you drawing?"

"Devil's trap. Keeps demons out," Sam said, without taking his eyes off the floor.

"Do you want me to get the doc?"

"How's he going to help?"

Jeremy scratched at his ear, trying to think of something to say other than: _he can suggest sedation._"You could tell him why you think you need to protect yourself against demons."

Sam shuffled over a foot to the right and kept drawing.

* * *

Later that afternoon, in the day room, Sam sat at his usual table still holding the black crayon. He'd removed the wrapper and worn it down to a nub drawing another pentacle around his chair. His slippered feet were placed carefully between the lines. He'd started drawing on the table, too — nothing to worry about since all the crayons they had were the washable kind. Jeremy couldn't tell exactly what Sam was drawing now. It looked like an upside down triangle with a "v" underneath it.

The day room had felt cold, this last week. Odd, since it was only September, and it was in the mid sixties outside. Jeremy had never been a temperature-sensitive kind of guy, but today he felt a chill he just couldn't shake. He wrapped his arms around himself, feeling the goose-bumps on his bare forearms, and watched Sam continue to work on his symbol.

Sam only stopped drawing when Nick joined him at the table. Nick took the crayon gently from Sam's hand, added a few more lines to his symbol and then sat, putting the crayon stub down carefully next to the chessboard. He tilted his head to the side and moved his knight.

Something about the way they played was unnerving. Jeremy had watched plenty of chess games in his life; even played a few himself, but the way these two played... It felt like there was something else going on. The way Sam reacted sometimes, to certain moves — his jaw clenched, his eyes narrowed. It looked almost like he was having a silent argument with Nick.

Sam won the first round. Even if Jeremy hadn't seen him take Nick's king, he would've known just from the smile on his face.

Nick didn't seem too disappointed, though. He applauded softly and started to reset the pieces.

It was quiet for the next hour or so until Meg came into the room holding a tray loaded with little paper cups full of pills. Sam stood up so quickly his chair fell over. Nick held his hand up towards Sam in a calming gesture and then turned to look at Meg. She stopped where she was, cocked her head to the left and smiled over to Nick. Once again, Jeremy felt like everyone around him was having wordless conversations. Meg nodded to Nick, and then brought her tray to the other side of the room.

Nick took Sam gently by the arm and walked him over to Jeremy. "Have someone else bring Sam his pills," Nick said. "He doesn't trust her. She reminds him of someone from his past. Somebody he has good reason to distrust."

Shifting uneasily from one foot to the other, Sam never took his eyes off of Meg. So quietly, Jeremy had to strain to hear him, Sam said, "I'd like to go back to my room, please."

Jeremy nodded, shivering, as Sam followed him out of the day room and Nick waved good-bye. It felt so cold in there, lately.

* * *

Dinner went by without incident. They'd included fruit shakes with the meals tonight. Banana and strawberry and something else — they smelled really good. So good, that after delivering all the meals to the patients in Hall C, he doubled back to the break room to see if there were any leftovers. Meg was working the blender, and bobbing her head, like she was singing something over the noise of the ice being crushed. Apparently she'd worked at a smoothie stand as a second job back in college, and knew a few tricks.

"Is that a spare, by any chance?" he asked hopefully.

"Nope," Meg said. "Nick wanted seconds." She batted her eyelashes at Jeremy. "I think he just wants to see me again."

"Oh really?" Jeremy said, chuckling. "You think you're that irresistible?"

"I know I am," she said, pouring the contents of the blender into a big styrofoam cup. She winked at Jeremy and left the room, swaying her hips as she walked.

Full of herself, but kind of cute. Jeremy shook his head smiling, and looked into the little employee fridge to see if he had anything left. He was pretty sure he had an apple stashed away somewhere. Sadly, he was wrong, and found his part of the shelf completely empty. He wandered down to the vending machine by the elevator in defeat and had to make do with potato chips — baked and therefore healthier. Woohoo.

After the less than satisfactory snack, he started his clean-up round. He pushed his cart into Sam's room, collected the empty tray from the table by the door and walked over to Sam's bed to get the smoothie cup. He was surprised to find it completely full.

Holding the cup of fruity liquid out to Sam, he asked, "You want me to leave this?"

Sam shook his head.

"I hear they're good."

"I can smell her. She made this."

The statement didn't make any sense. He assumed Sam meant Meg, but she didn't wear any perfume. "Okay."

"She put something in it."

"Strawberries, banana..."

Sam gave him a withering look. "Something else."

Jeremy shrugged and looked down at the cup in his hand as he started to head towards the door. "In that case, mind if I have this?"

Before Jeremy could even process what happened, Sam had leapt off of his bed and backhanded the cup out of Jeremy's hand. It sailed through the air, spilling across the floor, decorated once again with a large pentacle, this time in blue.

The pink liquid bubbled and fizzed where it touched Sam's scribbling, and Jeremy wondered if Meg had carbonated the shake somehow. Or maybe it had spoiled. He'd had a piece of bad pineapple once a few months back and it had made his tongue all tingly.

Sam backed away from the spilled drink. "It's poison."

Jeremy took a deep breath. "I'll go get the mop."

* * *

The next week began uneventfully. Sam spoke even less than usual, but his chess matches with Nick got longer every day.

Then Nick got sick.

At first they thought he'd contracted a rare virus of some kind. His skin had gone deathly pale and lesions were starting to appear on the back of his hands and on his face, along his temples. They grew larger every day, broken skin peeling back to show angry red tissue underneath.

Doc Martin brought over one of the viral experts from the closest hospital, who confirmed that whatever Nick had wasn't contagious, but he also had no idea what had caused his sudden deterioration. Nick was given a prescription of heavy duty antibiotics, and was told to stay in his bed. He needed to rest, and rest he did — too weak to sit up for very long. Most mornings, Jeremy came in to find Nick sleeping, a spot or two of blood on his pillow from the wounds on his face.

Without Nick there to keep him busy, Sam got fidgety in the dayroom. He tapped his large feet against the floor at a faster and faster rhythm until finally, after twenty minutes, he picked up the chess set and asked to go to Nick's room. He stayed there for the next three hours, with the game set up on Nick's bed-tray. Meg was smart enough to leave them alone.

* * *

"You're a good man, Sam." Jeremy told him that afternoon. "I know Nick doesn't talk much, but he really appreciates your visits. That much is obvious."

Sam scoffed. "Doesn't talk much? He never shuts up."

Jeremy had never heard them speak to each other, beyond a cursory greeting.

"It's my fault he's sick," Sam said.

"What do you mean?" Jeremy's gut clenched unpleasantly. "Why would you say that?"

"I won't give him what he needs."

"What is it that he needs?"

"Me."

* * *

Jeremy felt obligated to tell Doc Martin and everybody else what Sam had said, just in case it meant something. But the nurses were taking blood samples from Nick every day because of his deteriorating condition, and would have detected anything harmful in his system. They didn't find anything unusual that night or the following morning either, just a slightly elevated concentration of sulfur. Like Sam, Jeremy thought, wondering if that meant something. The antibiotics hadn't helped Nick either; his body temperature was getting lower every day, and his dermal necrosis had gotten worse, not better — the patches growing larger and deeper to the point where a white shimmer of bone peeked out from underneath the inflamed tissue along his left temple.

Meg told Jeremy they were going to transfer Nick over to an intensive care ward at a nearby hospital that afternoon. They had to figure out what was causing his tissue to attack itself.

"Nick's being transferred today," Jeremy told Sam when he came back to his room after breakfast. "They have to find out what's making him sick."

Sam looked up at him, his eyes wide. He swallowed and looked towards the window. It was raining, and the sky was a gloomy grey. "Can I go over to his room early, then? We could get a few games in before he leaves."

Jeremy hesitated for just a second. "I'll check with the doc, but I think it's probably too dangerous. His immune system's all out of whack. Usually, in cases like this, they don't want to risk any other germs getting into the mix."

"I'm not sick."

"I know you're not, but better to be safe, right? I'll ask the doc, though. Okay?"

Sam nodded.

* * *

After he finished cleaning up the breakfast trays, Jeremy asked Frank if he'd seen Doc Martin around. Frank hadn't, but told him to go check on the main floor, where they were both headed anyway. As they headed towards the elevator together, Jeremy saw Nick's door swing shut.

They walked quietly over to Nick's room, where Sam was sitting in the chair, by the side of Nick's bed.

Sam and Nick were silent as usual. They played slowly, Nick's fingers shaking as he moved his piece, never taking his eyes off of Sam.

When it was his turn again, Sam picked up his queen and paused, holding the piece in mid-air. His shoulders hunched and he put the piece back down on the board carefully. Then he stood up and turned to Jeremy and Frank. "We need a few minutes alone."

Jeremy told Sam that was against policy, and that he should go back to his room, for his own safety and for Nick's. At least, he thought he did. But then he found himself in the staff break room with Frank asleep at the table.

He threw open the door, ran down the hall and around the corner to Nick's room. The door was closed, and Jeremy couldn't hear a thing from inside. He leaned his ear against the wall, right by the edge of the door, but still couldn't hear anything besides the rush of his own blood as his heart pounded faster and faster.

His fingers felt slippery as he reached for the door handle and pushed down. The room was _freezing_, and Jeremy's breath came out in a small white puff of air as he walked in.

Nick was lying on the bed, deep asleep. Sam was sitting next to him, facing the window, his back turned to the door. But what made Jeremy wish he'd transferred out months ago was Meg — spread out on the floor, deep red gashes running vertically up both of her wrists. A large pool of blood surrounded her, reaching all the way up to her head, where it had started to soak into the lower strands of her dark hair. Her eyes were open and completely empty.

"Sam?" Jeremy asked, when his voice started working again.

Sam didn't react.

Moving one slow step at a time, Jeremy walked towards the bed until he could reach the intercom, hanging off the edge of the bed. His hand was shaking so badly the remote slipped from his fingers the first time he grabbed for it. "Room 66. Hurry."

At the sound of Jeremy's voice, Sam's head turned. _Blood everywhere, red teeth, shadows spilling out of his back — wings — so huge they filled the entire room._There was a sound like broken bells and a choir of screams and then the whole world fell away in jagged chunks.

* * *

"What do you mean you don't remember?"

Jeremy rubbed at his temples trying to clear the fog from his head. "I— I don't remember what I saw." He was sitting on a chair in the break room, and there was an FBI agent looming over him.

"You said they were playing chess," the agent said. He had light green eyes, long lashes and the kind of jaw you usually saw on male models. He also looked like he knew three dozen ways to kill a man, bare-handed. Not exactly what Jeremy had expected from an agent.

"Yeah — yeah they were." Jeremy looked up at the agent's humorless face nervously. "Look, agent…"

"Bonham."

"Agent Bonham, I swear if I remembered anything, I would tell you. All I remember is that they were playing chess, and then…and then you were here."

The FBI agent straightened, squaring his shoulders. "So you have no idea why there's a dead nurse on the floor and a catatonic man in the bed." The thin smile on his face looked like a warning.

Jeremy shook his head.

"And you have no idea at all where Sam Winchester is."

Something in the back of Jeremy's head twinged. "Who's Sam Winchester?"


End file.
